A new guideline for the treatment of high blood pressure has been released. When the blood pressure reaches 140/90, do I need to take medicine?

Hypertension is the greatest threat to human beings, and its related cardiovascular and cerebrovascular diseases consume a lot of medical resources and have become a burden to all countries in the world. To reduce this burden, on May 6, the International Society of Hypertension (ISH) developed the ISH2020 International Hypertension Practice Guidelines that are applicable globally. Compared with the previously implemented guidelines for the treatment of hypertension, the latest version has undergone many changes.

For the definition of hypertension, there was no change in hospital office blood pressure, which is the same as the standard used in most countries around the world. That is, after repeated measurements, the diagnosis of hypertension can be made when the systolic blood pressure (high pressure) in the office is greater than or equal to 140 mmHg, or the diastolic blood pressure (low pressure) in the office is greater than or equal to 90 mmHg. The US version of 130/80mmHg is not used as the standard.

In the new guidelines, the interference of hospital clinics on blood pressure is still considered, and home self-measured blood pressure is greater than or equal to 135/85mmHg as the standard for hypertension. If ambulatory blood pressure is measured, the 24-hour average blood pressure is greater than or equal to 130/80 mmHg as hypertension.

Different from the previous classification of hypertension into three levels, the latest guidelines have a more streamlined classification of hypertension, only divided into two levels. Grade 1 hypertension is defined as systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-99 mmHg. Grade 2 hypertension was defined as systolic blood pressure greater than or equal to 160 mmHg, or diastolic blood pressure greater than 100 mmHg. The classification of grade 3 hypertension above 180/110 mmHg was cancelled.

This way of grading is easier for people to understand, with grade 1 being mild, and grade 2 being severe. It shows that when the blood pressure exceeds 160/100mmHg, the damage to the human body is already very serious. It has positive significance for urging people to pay attention to their own blood pressure and prevent cardiovascular diseases.

In most previous hypertension guidelines, the recommended blood pressure target is below 140/90mmHg, and elderly patients over 65 years old should control blood pressure below 150/90mmHg. But in the new guidelines, people with high blood pressure are divided by age. For hypertensive patients younger than 65 years old, the blood pressure control target is 130/80 mmHg, and for elderly hypertensive patients over 65 years old, the blood pressure control target is 140/80 mmHg.

In other words, the blood pressure control target is now lower than before, and this change will better protect the health of people with high blood pressure. Because in the occurrence of high blood pressure complications such as heart failure and decreased renal function, it is often necessary to control the blood pressure below 130/80 mmHg to stop the progression of the disease. So for hypertensive patients, a lower blood pressure value means a greater benefit.

The new guidelines state that blood pressure treatment is required when blood pressure reaches or exceeds 140/90 mmHg. In the guidelines, it is also clarified that improving lifestyle is the first-line antihypertensive treatment. These include reducing salt intake, eating healthy, limiting alcohol intake, quitting smoking, controlling weight, exercising regularly, reducing stress, reducing exposure to polluted air, and keeping warm.

The blood pressure target is less than 130/80mmHg (140/90mmHg in the elderly), and if this goal cannot be achieved by improving lifestyle, drug therapy is required to achieve blood pressure target.

It is worth noting that the new guidelines point out that people with high blood pressure (systolic blood pressure of 130-139 mmHg, or diastolic blood pressure of 85-89 mmHg), if they have hypertension syndromes such as kidney disease, diabetes, cardiovascular disease, etc. , also belong to the high-risk group. Treatment is also required to bring blood pressure below 130/80mmHg.

To sum up, in the new hypertension guidelines, what is closely related to hypertensive patients is the lower blood pressure control target. People whose blood pressure reached 140/90mmHg in the past is only considered to have just "stepped on the line" and can consider not taking medicine. The current blood pressure control target is 130/80mmHg. If the life intervention is ineffective, you need to take medicine.

The new guidelines for hypertension are an important reference for treatment, but the specific treatment cannot be "on paper" and should still be based on the judgment of clinicians. Medication needs to be carried out under the guidance of a doctor. If you find any problems during the medication process, please consult your doctor or pharmacist in time. I am Huazi, a pharmacist. Welcome to follow me and let me be a pharmacist by your side.

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